Peripheral nerve stimulation enables somatosensory feedback while suppressing phantom limb pain in transradial amputees

To simultaneously treat phantom limb pain (PLP) and restore somatic sensations using peripheral nerve stimulation (PNS), two bilateral transradial amputees were implanted with stimulating electrodes in the proximity of the medial, ulnar and radial nerves. Application of PNS evoked tactile and proprioceptive sensations in the phantom hand. Both patients learned to determine the shape of invisible objects by scanning a computer tablet with a stylus while receiving feedback based on PNS or transcutaneous electrical nerve stimulation (TENS). One patient learned to use PNS as feedback from the prosthetic hand that grasped objects of different sizes. PNS abolished PLP completely in one patient and reduced it by 40-70% in the other. We suggest incorporating PNS and/or TENS in active tasks to reduce PLP and restore sensations in amputees.

Automated summary

By implanting stimulating electrodes near the medial, ulnar, and radial nerves in two bilateral transradial amputees, tactile and proprioceptive sensations in the phantom hand could be evoked using peripheral nerve stimulation (PNS). Both patients were able to determine the shape of invisible objects by scanning a computer tablet with a stylus while receiving feedback based on PNS or transcutaneous electrical nerve stimulation (TENS). PNS completely abolished phantom limb pain (PLP) in one patient and reduced it by 40-70% in the other. Incorporating PNS and/or TENS in active tasks is suggested to reduce PLP and restore sensations in amputees.